Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia
Abstract Background The World Health Organization (WHO) recommends a minimum of eight ANC contacts during pregnancy, of which having one ultrasound examination before 24 weeks of gestation is indicated. Ultrasound plays a significant role in the surveillance and management of high-risk pregnancies....
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Pregnancy and Childbirth |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12884-022-04609-y |
| _version_ | 1818354688389545984 |
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| author | Meselech Assegid Roro Abebech Demissie Aredo Tesfaye Kebede Abiy Seifu Estifanos |
| author_facet | Meselech Assegid Roro Abebech Demissie Aredo Tesfaye Kebede Abiy Seifu Estifanos |
| author_sort | Meselech Assegid Roro |
| collection | DOAJ |
| description | Abstract Background The World Health Organization (WHO) recommends a minimum of eight ANC contacts during pregnancy, of which having one ultrasound examination before 24 weeks of gestation is indicated. Ultrasound plays a significant role in the surveillance and management of high-risk pregnancies. However, the obstetric ultrasound coverage in resource limited settings remains low. Evidence examining the barriers and facilitators to obstetrics ultrasound use in a resource-limited setting like Ethiopia is lacking. This qualitative study explored the facilitators and barriers to introducing obstetric Vscan Access ultrasound in primary health care facilities in Ethiopia. Methods The study employed a qualitative descriptive exploratory study design using in-depth interviews (IDIs) and focus group discussions (FGDs). The study participant were mothers who have had recent birth, community members, maternal and newborn service providers, and their managers. We employed an inductive thematic analysis to analyze the data. Result We conducted a total of ten FGDs, three with community members and seven with maternal and newborn service providers, and 52 IDIs with the service providers and health facility managers. Two major themes, health system related and client-related factors, emerged from the analysis. The health system related enablers include increased knowledge and skill of the providers, improved mothers and providers’ motivation, increased service utilization, and improved quality of maternal and newborn care (MNC), and enhanced referral system. The health system related barriers include service interruption, staff shortage/workload, and the providers’ limited capacity. Under the main theme of client-related factors, barriers include perceived limited knowledge and skills of providers and the small size of the ultrasound machine while the facilitators include mothers’ needs and interest in ultrasound scan, availability of free of charge ultrasound service, and increased demand for ultrasound scan service. Conclusion Our data suggest that the health system provides an enabling context to introduce limited obstetric ultrasound service and routinely provide the service through mid-level maternal care providers at primary health care level in resource limited settings. Overcoming the health system and client related barriers will maximize and sustain the use of the technology. |
| first_indexed | 2024-12-13T19:29:24Z |
| format | Article |
| id | doaj.art-169c354c6d4146aa8757c5e52dfa6276 |
| institution | Directory Open Access Journal |
| issn | 1471-2393 |
| language | English |
| last_indexed | 2024-12-13T19:29:24Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Pregnancy and Childbirth |
| spelling | doaj.art-169c354c6d4146aa8757c5e52dfa62762022-12-21T23:33:57ZengBMCBMC Pregnancy and Childbirth1471-23932022-04-012211910.1186/s12884-022-04609-yEnablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of EthiopiaMeselech Assegid Roro0Abebech Demissie Aredo1Tesfaye Kebede2Abiy Seifu Estifanos3Department of Reproductive, Family and Population Health, School of Public Health, Addis Ababa UniversityDepartment of Reproductive, Family and Population Health, School of Public Health, Addis Ababa UniversityDepartment of Radiology, School of Medicine, Addis Ababa UniversityDepartment of Reproductive, Family and Population Health, School of Public Health, Addis Ababa UniversityAbstract Background The World Health Organization (WHO) recommends a minimum of eight ANC contacts during pregnancy, of which having one ultrasound examination before 24 weeks of gestation is indicated. Ultrasound plays a significant role in the surveillance and management of high-risk pregnancies. However, the obstetric ultrasound coverage in resource limited settings remains low. Evidence examining the barriers and facilitators to obstetrics ultrasound use in a resource-limited setting like Ethiopia is lacking. This qualitative study explored the facilitators and barriers to introducing obstetric Vscan Access ultrasound in primary health care facilities in Ethiopia. Methods The study employed a qualitative descriptive exploratory study design using in-depth interviews (IDIs) and focus group discussions (FGDs). The study participant were mothers who have had recent birth, community members, maternal and newborn service providers, and their managers. We employed an inductive thematic analysis to analyze the data. Result We conducted a total of ten FGDs, three with community members and seven with maternal and newborn service providers, and 52 IDIs with the service providers and health facility managers. Two major themes, health system related and client-related factors, emerged from the analysis. The health system related enablers include increased knowledge and skill of the providers, improved mothers and providers’ motivation, increased service utilization, and improved quality of maternal and newborn care (MNC), and enhanced referral system. The health system related barriers include service interruption, staff shortage/workload, and the providers’ limited capacity. Under the main theme of client-related factors, barriers include perceived limited knowledge and skills of providers and the small size of the ultrasound machine while the facilitators include mothers’ needs and interest in ultrasound scan, availability of free of charge ultrasound service, and increased demand for ultrasound scan service. Conclusion Our data suggest that the health system provides an enabling context to introduce limited obstetric ultrasound service and routinely provide the service through mid-level maternal care providers at primary health care level in resource limited settings. Overcoming the health system and client related barriers will maximize and sustain the use of the technology.https://doi.org/10.1186/s12884-022-04609-yLimited obstetrics ultrasoundVscan ultrasoundEnablersBarriersQualitative |
| spellingShingle | Meselech Assegid Roro Abebech Demissie Aredo Tesfaye Kebede Abiy Seifu Estifanos Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia BMC Pregnancy and Childbirth Limited obstetrics ultrasound Vscan ultrasound Enablers Barriers Qualitative |
| title | Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia |
| title_full | Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia |
| title_fullStr | Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia |
| title_full_unstemmed | Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia |
| title_short | Enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource-limited setting: a qualitative study in four regions of Ethiopia |
| title_sort | enablers and barriers to introduction of obstetrics ultrasound service at primary care facilities in a resource limited setting a qualitative study in four regions of ethiopia |
| topic | Limited obstetrics ultrasound Vscan ultrasound Enablers Barriers Qualitative |
| url | https://doi.org/10.1186/s12884-022-04609-y |
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